Vision screening among hearing-impaired school children in Biratnagar, Nepal

Background: The prevalence of hearing impairment in Nepal is 16.5%, affecting approximately 2.71 million people. Deaf children are visually dependent, and even a mild refractive error may cause visual discomfort. The goal of this study was to determine the need for vision screenings in schools for the hearing impaired in Biratnagar, Nepal. Methods: A cross-sectional study was conducted with permission from Birat Deaf Secondary School, Biratnagar, Nepal. A total of 130 hearing-impaired students were examined. Non-invasive, comprehensive optometric examinations were performed to detect visual disorders. When a more detailed evaluation was needed, the students were referred to the Pediatric Ophthalmology Department, Biratnagar Eye Hospital Biratnagar, Nepal. Results: Of the 130 hearing-impaired students, 58 (44.6%) were male and 72 (55.4%) were female. The mean ± standard deviation of age was 16.03 ± 3.8 years (range 6–25 years). Twenty-one (16.1%) students had refractive errors: 13 (10%) had myopia, 7 (5.4%) had hyperopia, and 1 (0.8%) had anisometropia. In the cover test, 88 (67.7%) had orthophoria, 19 (14.6%) had exophoria, 11 (8.5%) had esophoria, 5 (3.85%) had exotropia, and 3 (2.3%) had esotropia. Cover tests were not performed in 4 (3.1%) students, as they were unable to fixate due to nystagmus or decreased vision. On ocular examination, 20 (15.3%) students had anterior segment abnormalities, including lid abnormality, conjunctivitis, Bitot’s spots, pterygium, corneal opacity, and lenticular opacity. Posterior segment or retinal abnormalities were found in four students with one having Usher syndrome. Color vision defects, nystagmus, and amblyopia were found in 8 (6.1%), 2 (1.5 %), and 1 (0.8%), respectively. Conclusions: The findings of the present study reflect the need of periodic vision screenings in schools for the hearing impaired in Nepal. These children are at a high risk of vision impairment. How to cite this article: Sah SK, Thakur R, Adhikari PR. Vision screening among hearing-impaired school children in Biratnagar, Nepal. Med Hypothesis Discov Innov Optom. 2021 Spring; 2(1): 36-40. DOI: https://doi.org/10.51329/mehdioptometry123 &nbsp

GABAa receptor α and γ subunits shape synaptic currents via different mechanisms

Synaptic GABAA receptors (GABAARs) mediate most of the inhibitory neurotransmission in the brain. The majority of these receptors are comprised of α1, β2, and γ2 subunits. The amygdala, a structure involved in processing emotional stimuli, expresses α2 and γ1 subunits at high levels. The effect of these subunits on GABA AR-mediated synaptic transmission is not known. Understanding the influence of these subunits on GABAAR-mediated synaptic currents may help in identifying the roles and locations of amygdala synapses that contain these subunits. Here, we describe the biophysical and synaptic properties of pure populations of α1β2γ2, α2β2γ2, α1β2γ1 and α2β2γ1 GABAARs. Their synaptic properties were examined in engineered synapses, whereas their kinetic properties were studied using rapid agonist application, and single channel recordings. All macropatch currents activated rapidly

Competition between Calcium-Activated K ϩ Channels Determines Cholinergic Action on Firing Properties of Basolateral Amygdala Projection Neurons

Acetylcholine (ACh) is an important modulator of learning, memory, and synaptic plasticity in the basolateral amygdala (BLA) and other brain regions. Activation of muscarinic acetylcholine receptors (mAChRs) suppresses a variety of potassium currents, including sI AHP , the calcium-activated potassium conductance primarily responsible for the slow afterhyperpolarization (AHP) that follows a train of action potentials. Muscarinic stimulation also produces inositol 1,4,5-trisphosphate (IP 3 ), releasing calcium from intracellular stores. Here, we show using whole-cell patch-clamp recordings and high-speed fluorescence imaging that focal application of mAChR agonists evokes large rises in cytosolic calcium in the soma and proximal dendrites in rat BLA projection neurons that are often associated with activation of an outward current that hyperpolarizes the cell. This hyperpolarization results from activation of small conductance calcium-activated potassium (SK) channels, secondary to the release of calcium from intracellular stores. Unlike bath application of cholinergic agonists, which always suppressed the AHP, focal application of ACh often evoked a paradoxical enhancement of the AHP and spike-frequency adaptation. This enhancement was correlated with amplification of the action potential-evoked calcium response and resulted from the activation of SK channels. When SK channels were blocked, cholinergic stimulation always reduced the AHP and spike-frequency adaptation. Conversely, suppression of the sI AHP by the ␤-adrenoreceptor agonist, isoprenaline, potentiated the cholinergic enhancement of the AHP. These results suggest that competition between cholinergic suppression of the sI AHP and cholinergic activation of the SK channels shapes the AHP and spike-frequency adaptation

Neglected fracture shaft femur presenting with pseudoaneurysm: a case report

A pseudoaneurysm is a collection of blood leaking from a damaged arterial wall. Development of the false aneurysm is due to either initial injury of the vessel or is a complication of internal fixation of the femoral fracture. Femoral artery pseudoaneurysms (FAPs) may close spontaneously if the tear is small enough to allow for clotting and sealing. On the other hand, rupture of the aneurysm can trigger thrombosis, distal embolization and compression of adjacent structures. We present a case of left superficial femoral arterial pseudoaneurysm in a 36-year-old male with fracture of left femoral shaft. A 36-year-old male with history of road traffic accident presented to our institute with pain and swelling in left thigh. Patient was investigated and diagnosed with fracture left femoral shaft with a pseudoaneurysm of the left superficial femoral artery (SFA). Stenting was done for SFA followed by open reduction and internal fixation of the femoral shaft fracture. Such cases require multidisciplinary approach and a proper planning with involvement of different medical specialities to achieve optimal results and to minimise any intraoperative and post operative complications

Functional properties and projections of neurons in the medial amygdala

The medial nucleus of the amygdala (MeA) plays a key role in innate emotional behaviors by relaying olfactory information to hypothalamic nuclei involved in reproduction and defense. However, little is known about the neuronal components of this region or their role in the olfactory-processing circuitry of the amygdala. Here, we have characterized neurons in the posteroventral division of the medial amygdala (MePV) using the GAD67-GFP mouse. Based on their electrophysiological properties and GABA expression, unsupervised cluster analysis divided MePV neurons into three types of GABAergic (Types 1-3) and two non-GABAergic cells (Types I and II). All cell types received olfactory synaptic input from the accessory olfactory bulb and, with the exception of Type 2 GABAergic neurons, sent projections to both reproductive and defensive hypothalamic nuclei. Type 2 GABAergic cells formed a chemically and electrically interconnected network of local circuit inhibitory interneurons that resembled neurogliaform cells of the piriform cortex and provided feedforward inhibition of the olfactory-processing circuitry of the MeA. These findings provide a description of the cellular organization and connectivity of the MePV and further our understanding of amygdala circuits involved in olfactory processing and innate emotions

A Specific class of interneuron mediates inhibitory plasticity in the lateral amygdala

The lateral amygdala (LA) plays a key role in emotional learning and is the main site for sensory input into the amygdala. Within the LA, pyramidal neurons comprise the major cell population with plasticity of inputs to these neurons thought to underlie fear learning. Pyramidal neuron activity is tightly controlled by local interneurons, and GABAergic modulation strongly influences amygdala-dependent learning. Synaptic inputs to some interneurons in the LA can also undergo synaptic plasticity, but the identity of these cells and the mechanisms that underlie this plasticity are not known. Here we show that long-term potentiation (LTP) in LA interneurons is restricted to a specific type of interneuron that is defined by the lack of expression of synaptic NR2B subunits. We find that LTP is only present at cortical inputs to these cells and is initiated by calcium influx via calcium-permeable AMPA receptors. LTP is maintained by trafficking of GluR2-lacking AMPA receptors that require an interaction with SAP97 and the actin cytoskeleton. Our results define a novel population of interneurons in the LA that control principal neuron excitability by feed-forward inhibition of cortical origin. This selective enhanced inhibition may contribute to reducing the activity of principal neurons engaged during extinction of conditioned fear

Effect of temperature on antibiotic properties of garlic (Allium sativum L.) and ginger (Zingiber officinale Rosc.)

Garlic and ginger are the two most common herbs used in traditional medicine practice for their antimicrobial activities. Moreover, in many countries, they are also used with boiled food preparations, which can destroy their important medicinal properties. We conducted an agar well diffusion assay with aqueous extracts of  garlic and ginger to observe the effect of temperature on their antibiotic properties against three human  pathogenic bacteria namely Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus. The results  show that in general, garlic has significantly greater zone of inhibition (mean = 23.3 mm) than ginger (mean = 19.0 mm) at both, room temperature (26°C) (t = 4.91; á = 0.05; P < 0.01) and at higher temperature  (100°C); garlic (mean = 15.6 mm); ginger (mean = 0 mm) (t = 17.76; df = 2; á = 0.05; P < 0.001). On  observation, it was found that although higher temperature significantly reduced the antibacterial properties of both plants, nevertheless it affected ginger more (t = 32.9, df = 2; á = 0.05; P < 0.001) than garlic (t = 11.5, df = 2; á = 0.05; P < 0.01). From our study, we can conclude that garlic has more prevailing and sustainable antibiotic properties than ginger under normal and higher temperature regimes. We recommend that garlic not only has very promising potential for a broad-spectrum antibiotic drug against many pathogenic bacteria, but  also significantly sustains its antibacterial property than ginger even with boiled food preparations. In addition, it can be used as an effective source of natural herbal antibiotics with or without boiling.Key words: Garlic, ginger, medicinal plants, antibiotic properties, naturopathy

Lesions of the basal forebrain cholinergic system in mice disrupt idiothetic navigation

Loss of integrity of the basal forebrain cholinergic neurons is a consistent feature of Alzheimer's disease, and measurement of basal forebrain degeneration by magnetic resonance imaging is emerging as a sensitive diagnostic marker for prodromal disease. It is also known that Alzheimer's disease patients perform poorly on both real space and computerized cued (allothetic) or uncued (idiothetic) recall navigation tasks. Although the hippocampus is required for allothetic navigation, lesions of this region only mildly affect idiothetic navigation. Here we tested the hypothesis that the cholinergic medial septo-hippocampal circuit is important for idiothetic navigation. Basal forebrain cholinergic neurons were selectively lesioned in mice using the toxin saporin conjugated to a basal forebrain cholinergic neuronal marker, the p75 neurotrophin receptor. Control animals were able to learn and remember spatial information when tested on a modified version of the passive place avoidance test where all extramaze cues were removed, and animals had to rely on idiothetic signals. However, the exploratory behaviour of mice with cholinergic basal forebrain lesions was highly disorganized during this test. By contrast, the lesioned animals performed no differently from controls in tasks involving contextual fear conditioning and spatial working memory (Y maze), and displayed no deficits in potentially confounding behaviours such as motor performance, anxiety, or disturbed sleep/wake cycles. These data suggest that the basal forebrain cholinergic system plays a specific role in idiothetic navigation, a modality that is impaired early in Alzheimer's disease

Action Potential Waveform Variability Limits Multi-Unit Separation in Freely Behaving Rats

Extracellular multi-unit recording is a widely used technique to study spontaneous and evoked neuronal activity in awake behaving animals. These recordings are done using either single-wire or mulitwire electrodes such as tetrodes. In this study we have tested the ability of single-wire electrodes to discriminate activity from multiple neurons under conditions of varying noise and neuronal cell density. Using extracellular single-unit recording, coupled with iontophoresis to drive cell activity across a wide dynamic range, we studied spike waveform variability, and explored systematic differences in single-unit spike waveform within and between brain regions as well as the influence of signal-to-noise ratio (SNR) on the similarity of spike waveforms. We also modelled spike misclassification for a range of cell densities based on neuronal recordings obtained at different SNRs. Modelling predictions were confirmed by classifying spike waveforms from multiple cells with various SNRs using a leading commercial spike-sorting system. Our results show that for single-wire recordings, multiple units can only be reliably distinguished under conditions of high recording SNR (≥4) and low neuronal density (≈20,000/ mm3). Physiological and behavioural changes, as well as technical limitations typical of awake animal preparations, reduce the accuracy of single-channel spike classification, resulting in serious classification errors. For SNR <4, the probability of misclassifying spikes approaches 100% in many cases. Our results suggest that in studies where the SNR is low or neuronal density is high, separation of distinct units needs to be evaluated with great caution